Research Journal of Recent Sciences ________________________________________________ ISSN 2277 - 2502
Vol. 1(ISC-2011), 207-211 (2012)
Res.J.Recent.Sci.

Prevalence of Different Factors Responsible for Infertility
Patel Mital1, Jain Shefali2, Jain Dinesh2, Patel Bhavesh1, Phanse Nandini1, Vyas Priti1 and Rathore Pragya3
1

PMB Gujarati Science College, Indore, MP, INDIA
Asian Institute of Infertility Management, Indore, MP, INDIA
3
Sanghvi Institute of Management and Science, Rau, Indore, MP, INDIA
2

Available online at, www.isca.in
(Received 17th November 2011, revised 10th March 2012, accepted 14th March 2012)

Abstract
The present paper deals with investigation of common causes of infertility in human beings. Among the 1000 cases studied at Asian
Institute of Infertility Management and Shefali Jain Test Tube Baby Centre during the period of Oct 2010 to Oct 2011, varied
outcomes were experienced. Among the infertility cases it is very clear that maximum infertility is due to female factors (30.2%).
Infertility in females was due to ovulation problem and most infertility cases were seen in age group of 35 to 40. Male factors also
contributed substantially (19.5%) to infertility. Causes of infertility in males is due to absence of sperm in semen (azoospermia),
low count of sperm, motility problem and most infertility cases were seen in age group of 35 to 40. However, in majority of
infertility cases (37%) the cause of infertility remain unexplained. All the 1000 cases were classified according to their occupations
in to 06 groups. Maximum cases were reported from the group I i.e. academicians, advocates, accountants, bank workers. Farmers
stood next in the infertility series. The rest of the groups are at average risk of infertility.
Keywords: Ethno air pollution, Low polluted area (LPA), heavy polluted area (HPA), foliar morphology.

Introduction
Challenges to human fertility arise from many conditions
caused by genetic abnormalities, infectious or environmental
agents and behavior. Aging also places limits to fertility.
Recent trends toward postponing age at first pregnancy have
highlighted the natural limits of fertility and accelerated the
development and use of medical technology to overcome
such limits. Half of the couple trying for pregnancy succeeds
within 3 months, increasing to over 85% by the end of first
year1. Infertility is defined by an unsuccessful waiting time to
pregnancy of 12 months, despite frequent unprotected
intercourse2. One in six couple is subfertile3. 30% of
subfertile couples have no identifiable medical cause 4 and
over 70% of these conceive within a further 24 months of
trying without medical help5. Thus Infertility is mainly
classified in two types; Primary Infertility is the term used to
describe a couple that has never been able to conceive a
pregnancy, after a minimum of one year of attempting to do
so through unprotected intercourse. Secondary Infertility is
the term used to describe couples who have previously been
pregnant at least once, but had not been able to achieve
another pregnancy.
Infertility affects men and women equally. Most infertility
cases (85-90%) were treated with medication or surgery.
Improvements in fertility treatment had made it possible for
many women to become pregnant. These new and advanced
technologies include Intra Uterine Insemination (IUI), In
Vitro Fertilization (IVF) and Intra Cytoplasmic Sperm
Injection (ICSI). Differences in individual and life style
characteristics have been suggested to have a role in the
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cause of infertility6-9 and in the success of treatment10-12.
Although much work still must be completed to fully
determine the involvement of various factors responsible for
infertility. Much of the research work is required to
determine interactions of genetics, environment and ethnic
background on fertility. Using this knowledge, clinicians will
be better able to treat infertile patients and make
knowledgeable decisions about the use of Assisted
Reproductive Techniques (ART).

Material and Methods
A survey was conducted at Asian Institute of Infertility
Management (AIIM) and Dr. Shefali Jain test tube baby
center, Indore, between Oct 2010 to Oct 2011. The study
includes 1000 cases of infertility who visited the center for
treatment. Male and female partners were interviewed and
counseled before any treatment. The interview questions
mainly included TTP- Time to Pregnancy (the interval of
exposure to unprotected intercourse from discontinuing birth
control methods till conception), contraceptive use,
pregnancy planning, previous fertility problems /
pregnancies, gynecological disease / surgery, individual
lifestyle factors including age, weight, height, tobacco
consumption, smoking, alcohol consumption, coffee and tea
intake, recreational drug use, known fertility/health problems
and surgery, and the couple’s coital frequency. Additionally
couple’s residential address, occupations and income were
also asked which can be used as an indicator of the living
standard. The information thus gathered was anonymous and
confidentiality was preserved.

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Research Journal of Recent Sciences _____________________________________________________________ ISSN 2277-2502
Vol. 1 (ISC-2011), 207-211 (2012)
Res.J.Recent Sci.

S.No.
1
2
3
4

Table-1
Infertility Etiology
Cause
No. of patients
Unexplained
370
Male factor
195
Female factor
302
Multiple factors
133

%
37
19.5
30.2
13.3

Results and Discussion
Out of the case history of 1000 patients, in 370 cases the
causes of infertility were unexplained, 195 corresponded to
male factor, 302 cases of infertility were because of female
factors while in 133 cases the cause remains multiple (table
1). Figure 1 shows the distribution of different female factors
viz. ovulation factor, tubal factor, endometriosis and uterine
problems in decreasing order. Similarly figure 2 shows the
cause of infertility in males, where the major contributors are
azoospermia, sperm count, motility and sperm morphology in
decreasing order.
The entire cases of infertility were divided into six groups as
shown in table 2. This will enable us to study the
interrelation of infertility and living standard, amount of
stress, occupational hazards etc. As observed in table the
group I have highest level of infertility followed by group II.
Rests of the groups are considered at moderate level.
Infertility is a global concern13. Approximately 167 million
ever married woman aged 15-49 years in developing
countries were infertile14. Infertility rates exceed 30% in subSaharan Africa14. According to UN ranking, India is on 77 th
rank and fertility rate from 2000-2005 is 3.11 and fertility
rate from 2005-2010 is 2.81. Infertility has multiple
dimensions, ranging from biomedical to the social. The
interactions between these factors are very complex and
difficult to understand. It is this reason even today in
majority of cases the reasons for infertility remains
unexplained. Our study also indicates that out of 1000 cases,
in 370 cases the reasons for infertility were unknown.
Variety of defects in male and female were responsible for
infertility. We have examined the proportion of different
factors in males and females responsible for infertility viz.
ovulation problem, tubal factor, endometriosis, uterine
problem in females and azoospermia, low sperm count,
motility and sperm morphology in males. The metabolic
disorder associated with poly cystic ovary (PCO) syndrome
has highlighted the link between overeating, insulin
resistance and endocrine changes that reduce fertility in
woman with poly cystic ovary syndrome15. Obesity is
associated with ovulatory and menstrual dysfunction,
infertility, increased risk of miscarriage and decreased
effectiveness of ART in woman16 and with erectile
dysfunction and decreased androgen production in man16.
Majority of infertility problems is preventable using available

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techniques. The age effect on fertility is certainly clinically
relevant. As shown in figure 3 and 4 infertility problems
increases with age in both males and females. The effect of
woman’s age on fertility is well recognized 17. Indeed
woman’s age is one of the two most important factors
influencing the probability of conceiving without medical
intervention in cases of unexplained subfertility; the other is
the duration of trying for pregnancy18. Furthermore, studies
of donor insemination, donor oocyte and in vitro fertilization
programe have demonstrated the important role that woman’s
age has in the success of the treatment. The effect of age of
males on infertility on the other hand, remains uncertain19.
In order to check and confirm other social and environmental
factors responsible for decrease in fertility the people of the
same kind of occupation are grouped together in our study. It
is clear from the data that the group I which comprises of
academicians, advocates, accountants, bank workers showed
highest level of infertility. Use of cotraceptive for delaying
child birth is more common among the profesionals and other
higher income groups, making this group more vulnerable to
the cumulative effect of the cause of infertility, including
ageing. Stress also is an important factor prevalent in
professionals, responsible for infertility. Group II comprise
of farmers which stood second in our study probably due to
their high exposure of pesticides and other harmful
chemicals. Although not indicated in the study but alcohol
consumption and use of tobacco in any form, particularly
smoking, has significant effect on decreasing fertility20-21.

Conclustion
Infertility is a very common problem for couples today. The
management of infertility is one of the most important tasks.
The age effect on fertility is certainly clinically relevant.
Infertility problems increase with age in both males and
females. Anatomical factors are responsible for infertility but
there are many other factors which are responsible for
infertility like pollution, urban/rural life style of people. Use
of contraceptive for delaying child birth is more common
among the profesionals and other higher income groups,
making this group more vulnerable to the cumulative effect
of the cause of infertility, including ageing. Stress also is an
important factor prevalent in professionals, responsible for
infertility. Assisted conception technique’s success rates are
not 100% because of complexity, expensive, lack of
awareness, fear and rituals of the people. Thus, the problem
of infertility can be managed to some extent by avoiding late
marriage, baby at right time, healthy life, good and healthy
food, junk food avoidance, medication, stress free life,
regular exercise.

References
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Res.J.Recent Sci.
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our

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Research Journal of Recent Sciences _____________________________________________________________ ISSN 2277-2502
Vol. 1 (ISC-2011), 207-211 (2012)
Res.J.Recent Sci.

Ovulation problem(36%)
Tubal Problems(29%)
Endometriosis(21%)
Uterine problem(14%)

Figure- 1
Female factors
Cause of infertility in females(n=302)

Azoospermia(50%)
Sperm count(23.5%)
Motility(17.5%)
Sperm morphology(9%)

Figure-2
Male factors
Cause of infertility in males(n=195)

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Research Journal of Recent Sciences _____________________________________________________________ ISSN 2277-2502
Vol. 1 (ISC-2011), 207-211 (2012)
Res.J.Recent Sci.
120
100
80

60
40
20
0
20-25

25-30

30-35

35-40

40-45 & above

Figure-3
Age group based division of infertile female patients and 04 indicates age distribution
among the female and male infertile cases respectively. As indicated in the table in both
female and male the cases of infertility increases up to the age of 40 years.
70
60
50
40
30
20
10
0
20-25

25-30

30-35

35-40

40-45 & above

Fig-4
Age group based division of infertile male patients

S.No.
1
2
3
4
5
6

Table-2
Occupations based division of infertile male patients
Occupations
Group I – Academicians, advocates, accountants, bank workers
Group II – Farmers
Group III – General store, Kirana marchants
Group IV – Cloth and garment businessmen
Group V – Labours, drivers
Group VI – Others (chemists, sanitation, furniture shop, showroom
workers)

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No. of patients
381
176
127
85
74

%
38.1
17.6
12.7
8.5
7.4

157

15.7

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